[Challenges and opportunities of health governance: a case study in a small municipality].

Abstract

This study addresses the importance of governance from the perspective of smart and sustainable cities, as well as the creation of public value for citizens. The study demonstrated the dynamics of health governance through its characteristics and tools in São Lourenço do Oeste (SC), a small municipality in southern Brazil. The case study involved important governance arrangements, such as interstate health agreements for the care of citizens in the Unified Health System, and the municipality's participation in intermunicipal health consortia.Using semi-structured interviews and content analysis, theoretical and empirical categories were associated, demonstrating how health management can contribute to creating public value and offering quality of life to citizens. Health governance in São Lourenço do Oeste encompasses several approaches, including smart, data-driven, urban, regional, and technocratic governance. However, for sociotechnical and citizen-centered governance, additional actions are still needed. Advancing with experimental approaches and involving citizens in technological arrangements can centralize citizens in governance, improving decisions and policies to raise quality of life.